Basic Math: HL7 Interfaces from CPOE to Pharmacy to eMAR

In clinicians computerized provider order entry (CPOE) system, a medication order was generated for warfarin 7 mg daily. Using an HL7 interface message, the medication order was communicated to an external pharmacy system. The anticoagulation medications were reviewed, and the clinicians were surprised at the warfarin dosing—it was much higher than originally ordered. The clinicians ordered a dose of warfarin 7 mg daily, yet the order and the electronic medication administration record (eMAR) both indicated a dose of warfarin 14 mg. The original CPOE HL7 message that was sent to the pharmacy system was passed through an enterprise interface engine and then a CPOE interface engine before being received by the external pharmacy application and used the same route upon return to the CPOE system. The CPOE application accepted the verification with the dose modification from the pharmacy system and changed the order view and the eMAR view of the order to a dose of 14 mg.